A case of gastric cancer with delayed onset of tumor reduction effect by nivolumab therapy
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Immune checkpoint inhibitors may have different clinical effects compared with conventional anticancer drugs. An 85-year-old male received chemotherapy for recurrent gastric cancer. As liver metastasis progressed, nivolumab was introduced as a fourth line treatment. Progression of liver metastasis in size was observed in CT after 3 courses of nivolumab therapy. Nivolumab treatment was discontinued, because the general condition of the patient also worsened. However, his general condition improved as hepatobiliary enzyme levels, inflammatory response, and tumor markers improved. Liver metastasis was shrinking on the image, so we resumed nivolumab therapy. To the authors’ knowledge, this is the first case of pseudoprogression undergoing immunotherapy for gastric cancer. In this case, the antitumor effect was exhibited in a delayed manner and the tumor shrinkage was obtained.
KeywordsGastric cancer Nivolumab Pseudoprogression MSI
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent was obtained from all patients for being included in the study.
- 1.Kang YK, Boku N, Satoh T, et al. Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens (ONO-4538-12, ATTRACTION-2): a randomized, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017;390:2461–71.CrossRefGoogle Scholar
- 5.Hodi FS, Sznol M, Kluger HM, et al. Long term survival of ipilimumab-naive patients (pts) with advanced melanoma (MEL) treatment with nivolumab (anti-PD-1, BMS-936558, ONO-4538) in a phase 1 trial. J Clin Oncol. 2014;32:supple 15 s (abstr9002).Google Scholar
- 7.Safarty M, Moore A, Dudnik E, et al. Not only for melanoma. Subcutaneous pseudoprogression in lung squamous-cell carcinoma treated with nivolumab. Medicine. 2017;96:4(e5951).Google Scholar
- 11.Tran PN, Sarkissian S, Chao J, et al. PD-1 and PD-L1 as emerging therapeutic targets in gastric cancer: current evidence. Gastrointest Cancer. 2017;7:1–11.Google Scholar